The American journal of emergency medicine
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Electrical storm is defined as three or more sustained episodes of ventricular tachycardia, ventricular fibrillation, or appropriate cardioverter-defibrillator shocks during a 24-h period. These patients are notoriously difficult to manage. We present a case secondary to Chagas disease that was responsive to lidocaine. Although an uncommon presentation, given the large-scale population movement from South America, Chagas has an increased incidence and is an important diagnostic consideration in patients with new onset heart failure, arrhythmia, or electrical storm.
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We sought to develop a model to measure the acceleration and jerk vectors affecting the performance of High-Quality Cardiopulmonary Resuscitation (HQ-CPR) during patient transport. ⋯ This model reliably measured linear and angular off-balancing vectors experienced during the delivery of HQ-CPR in a moving vehicle. In this preliminary report, compression rate and full recoil appear to be HQ-CPR variables most affected in a moving vehicle.
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Skin and soft tissue infections account for 2% of emergency department visits annually, though more unusual causative bacteria associated with saltwater exposure may result in morbidity. Mycobacterium marinum represents a rare but important cause of cellulitis, which if untreated or improperly managed, can progress to dactylitis or osteomyelitis. ⋯ While doxycycline is one antibiotic providing saltwater coverage, M. marinum has variable sensitivities to anti-mycobacterial antibiotics, and thus biopsy helps confirm the diagnosis as well as provide sensitivities for treatment. Emergency clinicians should inquire about environmental risk factors when caring for patients with cellulitis, especially with atypical skin presentations, and consider M. marinum as a rare but important cellulitis etiology.